Inspection·March 5, 2024

F 0580 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Immediately tell the resident, the resident's doctor, and a family member of situations (injury/decline/room, etc.) that affect the resident. **NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on review of clinical records, and staff interview, it was determined that the facility failed to timely notify a resident's representative of a significant change in condition and the need to potentially commence a new form of treatment for one resident out of 17 sampled (Resident 1). Findings include: A review of the clinical record revealed that Resident 1 was admitted to the facility on [DATE], with diagnoses of dementia (a condition characterized by progressive or persistent loss of intellectual functioning, especially with impairment of memory and abstract thinking, and often with personality change, resulting from organic disease of the brain). Resident 1's quarterly Minimum Data Set assessment (MDS - a federally mandated standardized assessment process conducted periodically to plan resident care) dated October 9, 2023, revealed that the resident was moderately cognitively impaired. A nursing note dated December 28, 2023, at 7:38 PM revealed that the resident was seen by the physician and a dermatology consult was ordered for a cancerous lesion on the left side of the resident's face. There was no documentation found that the facility had contacted the resident's identified representative regarding this change in condition, or that the resident's representative had been made aware of the dermatology consult. A review of a nursing note dated February 14, 2024, at 8:15 PM revealed that the resident left the facility and was seen by dermatology. Nursing noted that the resident had a biopsy completed while at the appointment and had a neoplasm (abnormal tissue growth, a characteristic of cancer) of uncertain behavior to the left nasal area. There was no documented evidence that the resident's representative was made aware the resident was going out for an dermatology appointment or documented evidence that the resident's representative had been informed that the resident had a biopsy completed to rule out cancer of the resident's face. An interview with the Director of Nursing on March 5, 2024, at approximately 1:50 PM confirmed the facility failed to notify the resident's representative of the resident's change in condition. (continued on next page) Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation. LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER REPRESENTATIVE'S SIGNATURE TITLE (X6) DATE FORM CMS-2567 (02/99) Previous Versions Obsolete Facility ID: If continuation sheet Page 1 of 4 Event ID: 395466 Printed: 05/15/2026 Form Approved OMB No. 0938-0391 Department of Health & Human Services Centers for Medicare & Medicaid Services STATEMENT OF DEFICIENCIES AND PLAN OF CORRECTION (X1) PROVIDER/SUPPLIER/CLIA IDENTIFICATION NUMBER: (X2) MULTIPLE CONSTRUCTION 395466 B. Wing A. Building (X3) DATE SURVEY COMPLETED 03/05/2024 NAME OF PROVIDER OR SUPPLIER STREET ADDRESS, CITY, STATE, ZIP CODE Milford Rehabilitation and Healthcare Center 264 Route 6 & 209 Milford, PA 18337 For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency. (X4) ID PREFIX TAG SUMMARY STATEMENT OF DEFICIENCIES (Each deficiency must be preceded by full regulatory or LSC identifying information)